exemestane at a glance
Medicine class
Irreversible steroidal aromatase inhibitor
Usual role
Endocrine treatment for eligible postmenopausal women with hormone-sensitive early or advanced breast cancer
Taking the tablet
Take by mouth, preferably after a meal
Bone health
Oestrogen reduction can lower bone mineral density and increase fracture risk
What is exemestane used for?
Licensed uses include:
Adjuvant treatment of oestrogen-receptor-positive invasive early breast cancer in postmenopausal women following initial tamoxifen treatment.
Advanced breast cancer in naturally or medically postmenopausal women whose disease has progressed after anti-oestrogen treatment. Effectiveness has not been demonstrated for oestrogen-receptor-negative disease.
How does exemestane work?
After menopause, aromatase makes much of the body's oestrogen from androgen hormones. Exemestane binds irreversibly to aromatase, reducing oestrogen production and limiting stimulation of susceptible breast-cancer cells.
exemestane preparations and strengths
Tablet
Route: Oral
Strengths: 25 mg
How to take exemestane
Take the tablet by mouth, preferably after a meal. Follow the prescription label and contact the oncology team before stopping or changing treatment.
Dizziness, drowsiness or fatigue can affect driving or machinery use.
Check with a pharmacist or oncology team before starting non-prescription or herbal products.
exemestane side effects
Common or expected effects
- Hot flushes and increased sweating
- Joint, muscle or back pain and stiffness
- Fatigue, headache or dizziness
- Difficulty sleeping or low mood
- Nausea or abdominal discomfort
- Hair thinning, itching or rash
- Reduced bone density, osteoporosis or fractures
Get urgent medical advice
- Severe hypersensitivity reaction
- Hepatitis or impaired bile flow, particularly with jaundice
- Severe pustular or blistering skin reaction
- A fracture or sudden severe bone or joint pain needing prompt assessment
exemestane in pregnancy
Exemestane is contraindicated during pregnancy because animal studies showed reproductive toxicity and adequate exposed-pregnancy data are unavailable. Anyone who could become pregnant, including those around the menopause, should discuss contraception and menopausal status with the specialist team.
exemestane while breastfeeding
Exemestane is contraindicated while breastfeeding. It is unknown whether it enters human milk, so discuss feeding plans with the specialist team.
exemestane interactions
Ask the oncology team or pharmacist to check all prescribed, non-prescription and herbal products.
Oestrogen-containing treatments
May oppose exemestane's oestrogen-lowering action and should not be combined without specialist direction.
Rifampicin
Strong enzyme induction can substantially reduce exemestane exposure and may reduce effectiveness.
Common questions about exemestane
Answers are fully visible for fast scanning and source review.
Is exemestane chemotherapy?
No. It is endocrine anticancer treatment that lowers oestrogen by irreversibly inhibiting aromatase.
Does exemestane work for oestrogen-receptor-negative breast cancer?
Its effectiveness has not been demonstrated for oestrogen-receptor-negative advanced breast cancer.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.